The Art of Well-Being in the Veterinary Profession

Well-being can sometimes seem an ambiguous term; it is often simply described as being healthy and happy. For many people, though, achieving a state of well-being is a deeply personal experience.

How do you view your well-being, and more importantly, what does it look like in your day-to-day life?

Personal and professional well-being is a critical component of the veterinarian profession. The demands of day-to-day practice can be difficult to leave at the door at the end of the day.

What’s Happening in the Broader Profession?

Well-being is a hot topic in veterinary medicine. The pressures of the profession have been anecdotally referenced for years and notably exacerbated during the pandemic as social, physical, and economic factors squeezed veterinarians’ time and practices.

A 2020 study led by Dr. Andria Jones, a professor in the Ontario Veterinary College’s (OVC) Department of Population Medicine and the college’s former Director of Well-Being Programming, with former PhD candidate, Dr. Jennifer Perret, found that relative to the general population, survey participants in the veterinary profession had significantly higher scores for burnout and compassion fatigue, anxiety and depression, as well as significantly lower resilience. The study also found that women had significantly higher scores for perceived stress, emotional exhaustion, burnout, secondary traumatic stress, anxiety and depression, along with significantly lower resilience.

“I think the results have helped to confirm what many people in the field have reported anecdotally - that poor mental health and well-being are serious issues in veterinary medicine,” says Jones. “They have helped serve as a call to action for veterinary colleges, organizations, clinics, and others to make real differences to improve well-being.” Jones has launched an ambitious and well-received research program encompassing well-being studies in the agricultural and veterinary sectors.

In veterinary medicine, a shift is underway, and the ripples of change are evident. They are observed in the Doctor of Veterinary Medicine (DVM) curriculum and in the Association of American Veterinary Medical College’s (AAVMC) resident/intern well-being guidelines and well-being competencies guidelines. A greater focus on well-being is also reflected in the Ontario Veterinary Medical Association’s (OVMA) iMatter campaign - a platform to equip Ontario veterinarians with knowledge and strategies to help them better cope with and respond to the challenges they face in their professional and personal lives.

Dr. Joanne Hewson, OVC Associate Dean, Students and Academic, is seeing a positive trend across the profession. "I'm really encouraged with how members of our profession are beginning to shift our collective paradigm in order to have more focus on well-being; it's an overdue culture change, but one that our profession is embracing and one that I can see is happening more every day.”

Hewson adds, “I think graduates from the DVM program will continue to face challenges as they navigate their veterinary career, just as our colleagues have in the past. However, by being trained on skills to build resilience, and with the evolving focus on mental health throughout our profession, I feel today's graduates are better positioned now to have long and very satisfying careers."

Well-Being as a Trained Skill

Well-being is more than a goal to be achieved, it is a learned behaviour - and at OVC, it is being incorporated directly in the DVM curriculum. Just as student veterinarians practice critical thinking, decision making and clinical skills, they are also expanding their abilities and learning new techniques related to well-being.

Well-being topics are introduced to student veterinarians during their first few days on OVC’s campus. At Orientation Week, students are introduced to the concept of well-being and reminded of the importance of prioritizing their own mental and physical health throughout the rigorous four-year program.

First-year students are introduced to the domains of well-being as part of their coursework, as well as the concepts of emotional intelligence, fixed and growth mindsets, thought reframing, mind-body techniques, boundaries, and assertiveness; these elements become foundational to their studies. Additionally, a final year resilience rotation (first introduced in 2016) builds on these skills with a focus on self-awareness, mindfulness, self-compassion, mental health literacy, personal strengths and values, developing healthy habits, financial planning, and nutrition.

"Being directly involved in the delivery and assessment of student learning throughout the Resilience & Well-being for Veterinary Career rotation this year was an excellent opportunity for me to see this training in action,” says Hewson. “The students actively explored, experimented with and reflected on the many evidence-based tools they can use towards establishing and maintaining their own well-being as they enter the profession and take on roles as future leaders.”

Hewson noted that being part of the students’ journey as they tried out these skills - and in particular seeing them experience the positive impacts firsthand - underscored to her the importance of enhancing this practice and reflection throughout training within the first three years of the DVM program curriculum.

“Students really need to recognize from day one of our program that the skills to help them maintain well-being and be resilient throughout their careers are as important to learn and practice as are their clinical skills. This part of their training is not negotiable," adds Hewson.

For fourth-year student veterinarian Gordon Lo, OVC 2023, the rotation surpassed his expectations. “As a person who acknowledges the importance of resilience and self-care but am not particularly knowledged or practiced in it, I expected to feel overwhelmed, mentally inferior, or some form of imposter syndrome. Honestly, I didn't feel any of that. I was intrigued at the multitude of aspects that were relevant and discussed, and impressed at how much I was able to absorb,” says Lo. “I believe one of my biggest takeaways was that being resilient is not about perfecting one thing or skill. Rather, resiliency can be approached from so many forms of wellness, such as financial wellness, physical wellness, and emotional wellness. On top of that, I learned that talking about these resiliency topics in a safe environment is actually very thought provoking. I was able to learn from different perspectives from my peers, not to mention being closer to them as friends as a result!”

Hewson adds it was equally inspiring to hear insights from the veterinary practice owners and associates who joined the fourth-year students for open discussions on well-being in veterinary practice during the resilience and well-being rotation weeks.

“To hear their recognition of the importance of mental health, and the many ways that our profession is already actively adjusting the way we work, was a message of hope for our profession today and into the days ahead,” says Hewson. “The emphasis on intentional and supportive mentorship for new graduates as they begin their work career was also a clear theme heard from practice owners, demonstrating that the veterinary profession values and feels passionate about investing to ensure that our newest colleagues have a smooth and positive transition into their careers that better supports their overall well-being."

New in 2022: Personal and Professional Well-Being Competency

In April 2022, the OVC DVM Curriculum Committee approved a new Phase 4 Personal and Professional Well-Being competency and rubric - one of the 19 official OVC Phase 4 competencies that students are assessed on in their final year rotations.

With this addition, OVC graduates are expected to demonstrate the knowledge and skills related to well-being competency by the time they graduate.

“The new well-being curriculum will help our students learn and apply a wide variety of evidence-based skills and strategies that will help reduce the impact of occupational stressors, build resilience, and promote well-being in the veterinary profession,” says Jones.

Students are assessed on their ability to use evidence-based strategies to maintain or improve their well-being, engage in self-reflection, intentionally and consistently demonstrate how they are incorporating well-being strategies into their day, regularly contribute to a culture of well-being for themselves and their colleagues, and ask for assistance in these areas when needed.

More broadly, well-being has also been incorporated into the Kim and Stu Lang Community Healthcare Partnership Program (CHPP) curriculum as one of its five core curricular pillars, adds Hewson.

Established in late-2019 the CHPP brings OVC faculty, veterinarians and clinical staff, students and partners together to expand animal healthcare by providing primary and acute veterinary care to companion animals in populations including Indigenous communities, individuals experiencing housing-insecurity, and sheltered animals.

The well-being pillar is inextricably linked with other CHPP pillars, such as practicing cultural humility, providing a spectrum of care, and caring for vulnerable animals.

“Practicing shelter or community medicine can have unique challenges for well-being, but it can also work the other way as well,” says Dr. Lauren Van Patter, Kim & Stu Lang Professor in Community and Shelter Medicine. “Having the tools to improve access to veterinary care and meet needs for animal healthcare in underserved communities can mitigate some of the stresses commonly faced in the profession.”

Insights from the OVC Well-Being Project

Initiated in 2021, and borne out of the COVID-19 pandemic, the OVC Well-Being Project recognizes the negative impacts the pandemic has had on mental health and well-being and aims to give space to OVC community members to share their experiences and insights as to what would help.

Led by Jones, a research team comprised of veterinarians, epidemiologists, a psychologist, teaching faculty and graduate students, decided to extend the research beyond the pandemic in recognition of the ongoing issues facing veterinary team members and members of academic institutions generally and at OVC in particular. 

The team shared a preliminary report with the OVC community of faculty, staff and students in early 2023, summarizing key insights about the challenges and specific opportunities to improve the culture of well-being at OVC.

Through one-on-one interviews, focus groups with faculty, administrative staff, clinical and non-clinical staff, residents and interns, members of the college Well-Being Committee, the OVC Dean's Council, and DVM and graduate students, the team gathered information on work related stressors, existing well-being supports, and opportunities to improve well-being at work. They used focus groups with OVC community members to prioritize key solutions and pinpoint how different levels of the OVC community might champion well-being initiatives.

Key findings fell into four general categories: assessing and addressing overwork and exhaustion; prioritizing equity, inclusion and diversity; enhancing consultation and communication; and finding the “we” at OVC through a stronger community culture.

An in-depth thematic qualitative analysis is currently underway, says Jones’ graduate student lead Karli Longthorne, and further work is just getting started.

Along with ongoing consultation with the OVC community, the team will work alongside OVC leadership, the Dean’s office, the OVC College Well-being Committee, and Dr. Melissa Horne, OVC’s Advisor of Organizational Culture, to develop and implement tailored, short-, medium-, and long-term well-being programming.

“The research we have conducted with the OVC community over the past 3 years is now informing tailored programming and college-level strategies to help improve well-being at the OVC, and similar institutions more broadly”, says Jones.

Ongoing Research Examines the Mental Health Status of Ontario Veterinarians

Dr. Andria Jones research group continues to study the impact of well-being and mental health among veterinary professionals.

Recent MSc graduate Megan Campbell oversaw a study related to veterinary stressors and the impacts of high stress and poor well-being on the provision of veterinary care, and Jonesis collaborating with Dr. Caroline Ritter at the Atlantic Veterinary College (AVC) on a project on early career veterinarians aiming to assess and improve the mental well-being of final-year veterinary students and recent graduates in Canada. The longitudinal study focuses on graduating veterinarians from all five Canadian veterinary colleges across the first two years in practice.

Jones and Ritter are co-advising two PhD students focusing on this work: Tipsarp (Minnie) Kittisiam, in OVC’s Department of Population Medicine, and Emily Morabito, at AVC. They began their work with a questionnaire distributed in 2022 to all final-year veterinary students enrolled at Canadian veterinary schools. The questionnaire focused on positive mental health measures including eudaimonia (also described as fulfillment or living well), hedonia (loosely:  happiness), emotional intelligence, self-efficacy, and resilience. Researchers will send follow-up surveys to participants six, 12, and 24 months after graduation.

Based on results from the survey and qualitative interviews with veterinary students and veterinarians, the researchers will develop an intervention tool focusing on positive mental health. The tool will be evaluated, refined, and made available to student veterinarians and recent graduates to support positive mental health, especially during the first phase working as veterinarians.